176. CCA Study Notes: Health Care Teams and Teamwork Across Care Settings

The Big Picture

Health care teams bring people together to work toward the same goal, providing the client with the best possible care and support. Team members depend on each other to perform their roles well.

A team looks different depending on the workplace and the client’s needs. You might work with one supervisor, a small group, or a larger group of health care providers with different skills and specialties.

Good teamwork depends on communication, cooperation, trust, respect for each person’s role, and willingness to solve problems together.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

What a Health Care Team Does

A health care team is a group of people working toward a common goal. In health care, that goal is to provide the client with the best possible care and support.

Team members consider the whole client. This includes five dimensions of the client’s life:

• physical
• emotional
• social
• cognitive ⓘ
• spiritual

Team members depend on each other to perform their roles well. They also need to behave professionally and use correct terminology when reporting observations about a client.

Who Belongs to the Team

The members of a health care team depend on the workplace and the client’s needs.

The client usually belongs to the team unless the client is not mentally capable of participating or chooses not to participate.

A support worker might work in several different team arrangements.

Working With an Off-Site Supervisor

A support worker might work independently while the supervisor remains off-site.

The supervisor might stay available through:

• phone calls
• live video communication
• text messages

Working With One Supervisor

Sometimes the support worker and supervisor are the only health care providers present.

The supervisor might be a regulated ⓘ health professional, such as:

• a nurse
• a social worker
• a physiotherapist
• an occupational therapist

In some workplaces, the supervisor might instead be the owner of the facility.

Working With a Larger Team

A larger team might include health care providers from different backgrounds and specialties.

Examples include:

• physicians
• nurses
• support workers
• dietitians
• physiotherapists
• occupational therapists
• speech therapists
• providers of alternative care

Collaboration

Collaboration means working together toward a common goal.

Team members share useful information so other people involved in the client’s care benefit from what they have learned.

For example, a support worker might find a way to reduce a client’s discomfort during care. The support worker shares that information appropriately with the nurse and co-workers. The nurse might then include the approach in the client’s care plan.

Communication and Team Meetings

Team meetings give members a chance to share:

• experiences
• observations
• opinions
• ideas

Each team member contributes part of the overall picture of the client.

A support worker might have daily contact with the client and therefore have important observations to share. Other team members contribute information from their own areas of training and responsibility.

This combination of information helps the team understand the client’s situation more fully.

Mentorship

A mentor shares expertise and knowledge while creating a safe, encouraging learning environment for another person.

Newly hired support workers often learn from experienced co-workers while becoming familiar with:

• the agency
• its clients
• routine duties

Some workplaces formally assign mentors. Other experienced workers provide mentorship voluntarily.

Different Skills and Perspectives

Team members bring different:

• abilities
• skills
• training
• experience
• viewpoints

Each team member brings ideas and viewpoints based on their scope of practice.

Effective team members understand and respect each other’s scope of practice.

A support worker might also need to explain and advocate for their own role when working with other health care providers.

Support Workers Bring Important Information

Support workers often spend more time with clients than other team members.

Because of this regular contact, support workers might provide important information about:

• daily observations
• progress
• concerns
• basic assessment information

These contributions help other team members understand what has been happening with the client from day to day.

Decision Making and Problem Solving

A group of people often brings more information and different viewpoints to a problem than one person working alone.

Team members might discuss how to complete care more effectively while still following:

• safety principles
• client dignity
• legislation

Some tasks are taught using a particular sequence. In some circumstances, the order might change when safety, dignity, and legislation ⓘ still remain protected.

Discussing problems as a team supports sound decisions and appropriate solutions.

Trust Within the Team

Trust grows when team members:

• perform their jobs well
• respect each other
• mentor each other
• share responsibility

The team leader, also called the case manager, helps create an atmosphere where team members feel able to discuss problems openly.

Team members also help build trust by taking responsibility for their own actions instead of blaming others for their mistakes.

An effective team also supports members during difficult emotional situations, including the death of a client.

Respect Role Boundaries

Good teamwork does not mean every team member performs every task.

Team members need to understand and value each person’s role.

Support workers must know:

• their scope of practice
• their employer’s policies and procedures
• which tasks they are not permitted to perform

Role limit: Never take on a task that you are not allowed to perform.

Flexibility

Teamwork requires flexibility.

A support worker might agree to work on another unit when staffing needs change. This flexibility helps the team meet client-care needs.

Conflict Resolution

Disagreements happen within teams.

The way team members handle conflict affects the whole group. The team leader or case manager has an important role in helping resolve conflict.

Team members should feel comfortable discussing problems with their leader.

Problems should be addressed instead of being ignored in the hope that they disappear.

Expressing Your Needs and Views

Support workers might feel intimidated when working with physicians or other health care providers.

Support workers still have important information to contribute.

Because support workers spend considerable time with clients, their day-to-day reports about progress and concerns contribute to team communication. Registered staff hear these reports, and concerns are also reported to the supervisor.

How Teamwork Changes Across Care Settings

The members of a health care team and the way they communicate depend on the care setting.

Home Care

A home care team usually includes:

• the client
• family members
• the case manager
• the family physician
• nurses
• support workers
• support worker supervisors

Social workers and therapists might also belong to the team.

A case manager assesses, monitors, and evaluates the client’s needs in a community care setting. The case manager also coordinates the services of the team.

A case manager might be:

• a nurse
• a social worker
• another regulated health care provider

Occasionally, the client chooses to act as the case manager.

Home care teams do not always meet regularly. Team members might communicate through:

• mobile phone
• live video communication
• text messages
• written reports

The case manager arranges a team meeting when needed.

Community Day Programs

Team structure depends on the type of day program.

A rehabilitative ⓘ program team might include:

• a supervisor, often a nurse or another health care provider
• other professionals
• support workers

A recreational program team might include:

• a supervisor, usually a recreational or occupational therapist
• support workers

Support workers in day programs often work with the same team each day.

The team might discuss client progress:

• before the program
• after the program
• once a week

Teams in Facilities

Facility-based teams differ from one setting to another.

One common advantage is location. Team members usually work in the same place, which gives them more opportunities to meet, communicate, and collaborate.

Hospitals

Hospital teams differ between hospitals and departments.

Many departments use teams made up of health care providers from different backgrounds and specialties.

An interdisciplinary team includes health care providers from a variety of backgrounds and specialties who work together to meet the client’s needs. It is also known as an intradisciplinary team, interprofessional team, interprofessional health care team, or multidisciplinary team.

Long-Term Care Facilities

A long-term care team might include:

• physicians
• nurses
• social workers
• support workers
• therapists
• the client
• the client’s family

Larger facilities might also include:

• pharmacists
• activity directors
• dietitians
• other staff members

One nurse often acts as the team leader.

The same team might care for all clients in a facility. In larger facilities, each unit might have its own team.

Support workers might therefore work with many different health care providers.

Hospices and Palliative Care Units

A hospice or palliative care team might include:

• nurses
• support workers
• physicians
• social workers
• volunteers
• dietitians
• the client
• family members

Depending on the client’s wishes, another person such as a spiritual advisor might also participate.

Hospices and palliative care units are facilities, but they are also considered community-based services. Outreach programs provide palliative care to people at home.

Team members in outreach programs might meet at the facility or in the client’s home.

Family Conferences and Care Conferences

A family conference, also called a care conference, is a meeting where the health care team, the client when possible, and family members discuss the client’s care.

Family conferences take place regularly and when difficult situations arise.

They give family members opportunities to:

• ask questions
• express feelings
• take part in difficult decisions

These conferences are most common in hospice and community care settings. Hospitals and other facilities also use them.

Assisted-Living Facilities

Assisted-living facilities are community based and usually located in one building.

These facilities include group homes.

Having team members in one location makes communication easier.

These facilities usually have only a few staff members from different disciplines. The team depends on the needs of the clients.

A team commonly includes:

• a supervisor
• one or two support workers

The supervisor might be:

• a nurse
• a social worker
• a qualified youth care worker

Other assistive personnel might also belong to the team.